Million dollar lies and the surgeons who tell them

Is it just me, or have stories about doctors behaving badly become so commonplace that it feels like we need a new, amped-up phrase. Something that would better encapsulate the orgy of vile behavior that reflects poorly on the rest of my profession, thereby costing us all a chunk of our self-respect. Maybe something lighthearted? How about Docs Gone Wild?

So who was flashing what in our latest episode of doctor sleaze? This time, it’s surgeons – orthopedic surgeons, to be exact. A Washington think tank, titled the Institute on Medicine as a Profession, did a nifty bit of detective work. They compared those mandatory financial disclosure statements that scientific journals require authors to submit, to the pay-out reports from five (only 5!) medical device makers. In a tiny story that managed to provide several eye-popping results, here’s one of the first (brace yourself): they found over 41 orthopedic surgeons who had been paid between $1,000,000 and $8,800,000.

Cash.

Urk. Take a moment to imagine that amount. Now imagine someone handing it to you. In many, many suitcases full of hundred-dollar bills that you stack on your forklift to take home.

Given the fact that orthopedic surgeons are already one of THE most highly paid medical subspecialties, all I can say is, if that’s not gilding the lily, I don’t know what is.

Now for the second shocker. Take a flying guess what percent of surgeons who are publishing articles that directly applied to the donor of this big payola, actually confessed on their mandatory form to having gotten any money at all?

75%? Um, no.

Try half.

As in 50-50. A coin toss. And no one – no one at all – gave any hint of the magnitude of the pay-out they received.

The idea behind this study came from the impressive work that Senator Charles Grassley (R-Iowa) has done. Senator Grassley showed that highly placed psychiatrists (even at Harvard! My alma mater!) had been receiving whopping doses of cash from Big Pharma without admitting to it, even as they published supposedly-unbiased articles about their sugar daddy, oops, I mean benefactor, oops, I mean drugs.

On this latest lying-surgeon front, I’m left wondering what excuse the half who never admitted getting any cash is going to use. “A million? That ole thang? How was I supposed to notice it, lying back there under all the others?”

So besides the woozy-making dollar amounts involved, and the widespread number of Lies and the Lying Liar-Surgeons Who Tell Them, what was the third shocker in this tiny news announcement?

The third Docs Gone Wild moment of sleaze was the deafening silence about the journals themselves – the ones who published the articles. Like any good sex tape, the bedfellows were shown caught in the act, but no names were named. Who were they? Which papers? Which authors? I don’t know about you, but I can just imagine all the “peer review” journal staff scurrying around, putting together their press releases faster than you can whip off a shirt in Ft. Lauderdale.

But it makes you wonder – why the coyness? Why not name names? Aren’t we talking about something that looks, smells and feels an awful lot like fraud, after all? If nothing else, you’ve gotta ask, so when will the “mandatory” disclosure forms actually be, well…mandatory? And what about those of us wondering which hip replacement, or knee replacement, or other device, is now suspect?

Where’s the retraction?

If you were one of these journals’ editors or advisory boards, isn’t it past time you put your money where your mouth is?

Because the people who are really affected are the patients, and the people who care about them. Anyone walking around with an artificial hip or knee now has to wonder just a bit about it. That’s gonna cost us some sleepless nights. Even the total payout amount, $248 million, that doesn’t even begin to cover the total cost of worry, fret, and disillusionment here.

Somehow, when they created the old Lee Majors TV show about a man surgically enhanced with artificial parts, I don’t think this is what they intended by the phrase “Million Dollar Man.”

Of course, that’s just my two cents worth…

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